Cho Young Jae, Park In Seok, Kim Jungbin, Cho Hyun Jin, Gwak Geum Hee, Yang Keun Ho, Bae Byung Noe, Kim Ki Hwan
Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.
Ann Coloproctol. 2020 Aug;36(4):223-228. doi: 10.3393/ac.2019.09.30. Epub 2020 Jan 31.
Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.
We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.
The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).
The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.
小肠梗阻（SBO）是一种需要住院治疗的常见疾病。SBO最常见的病因是术后粘连。对于需要手术干预的患者，手术时机延迟会导致死亡率或发病率上升。多项关于SBO的研究已确立了急诊手术的标准。然而，几乎没有客观的临床参数可用于筛查需要延迟手术的患者。因此，我们分析了影响SBO临床病程的因素，以选择合适的治疗方案，降低这些患者并发症的风险。
我们调查了2015年1月1日至2016年12月31日期间我院外科收治的诊断为SBO的患者的临床特征。患者分为手术治疗组（n = 12）和保守治疗组（n = 96）。我们比较了两组之间的临床特征。
手术治疗组在发生SBO之前接受的手术比保守治疗组更多（P = 0.007）。手术组的初始白细胞计数（P = 0.004）和C反应蛋白（CRP）水平（P = 0.028）升高。手术组的体重指数（BMI）较低（P = 0.013）。
SBO发生前的手术次数、白细胞计数、CRP水平和BMI是选择需要对SBO进行紧急手术的患者的有用参数。
